<html><head>
        <title>Formulir Data Pindah Datang Penduduk</title>
        <link href="<?php echo base_url('assets/css/formpindahdatang.css') ?>" rel="stylesheet" type="text/css" />
        <link href="<?php echo base_url('assets/js/jquery-ui.css'); ?>" rel="stylesheet" type="text/css" />
        <script type="text/javascript" src="<?php echo base_url('assets/js/jquery-1.9.1.js'); ?>"></script>
        <script type="text/javascript" src="<?php echo base_url('assets/js/jquery-ui.js'); ?>"></script>  
        <script type="text/javascript">
            $(function() {
                $("#tgl_datang").datepicker({changeMonth: true, changeYear: true});
            });
        </script>             
    </head>
    <body>
        <form action="<?php echo base_url('pindah_datang/simpan_ubah'); ?>" method="post">
            <input type="hidden" name="nomor" value="<?php echo $data_pindahdatang->nomor; ?>" />
            <table width="90%" border="0" align="center">
                <tr>
                    <td colspan="5" class="trheader">Formulir Data Pindah Datang Penduduk</td>
                </tr>
                <tr>
                    <td>No.  Formulir Pindah</td>
                    <td colspan="4"><input type="text" name="idpindah_datang" id="idpindah_datang" class="textinput" value="<?php echo $data_pindahdatang->idpindah_datang; ?>" /></td>
                </tr>
                <tr>
                    <td>Kategori Pindah</td>
                    <td colspan="4"><select name="idkat_pindah" id="idkat_pindah" class="list" value="<?php echo $data_pindahdatang->idkat_pindah; ?>">
                            <?php
                            if (isset($kat_pindah)) {
                                foreach ($kat_pindah->result() as $data_kat_pindah) {
                                    echo '<option value="' . $data_kat_pindah->idkat_pindah . '">' . $data_kat_pindah->kat_pindah . '</option>';
                                }
                            }
                            ?>
                        </select></td>
                </tr>
                <tr>
                    <td>NIK Pemohon</td>
                    <td colspan="4"><input type="text" name="nik_pemohon" id="nik_pemohon" class="textinput" value="<?php echo $data_pindahdatang->nik_pemohon; ?>"/></td>
                </tr>
                <tr>
                    <td>Nama Pemohon</td>
                    <td colspan="4"><input type="text" name="nama_pemohon" id="nama_pemohon" class="textinput" value="<?php echo $data_pindahdatang->nama_pemohon; ?>"/></td>
                </tr>
                <tr>
                    <td colspan="5" class="jeda">Data Daerah Tujuan</td>
                </tr>
                <tr>
                    <td>Tanggal Kedatangan</td>
                    <td colspan="5"><input type="text" name="tgl_datang" id="tgl_datang" class="textinputtiga" value="<?php echo $data_pindahdatang->tgl_datang; ?>" /></td>
                </tr>
                <tr>
                    <td colspan="5" class="jeda">Data Daerah Asal</td>
                </tr>
                <tr>
                    <td>No. KK</td>
                    <td colspan="5"><input type="text" name="no_kk_lama" id="no_kk_lama" class="textinput" value="<?php echo $data_pindahdatang->no_kk_lama; ?>"/></td>
                </tr>
                <tr>
                    <td width="317">Nama KK</td>
                    <td colspan="5"><input type="text" name="nama_kk_lama" id="nama_kk_lama" class="textinput" value="<?php echo $data_pindahdatang->nama_kk; ?>"/></td>
                </tr>
                <tr>
                    <td>Alamat Asal</td>
                    <td colspan="4"><textarea name="alamat_asal" class="textaa" id="alamat_asal" rows="2" cols="51" ><?php echo $data_pindahdatang->alamat_asal; ?></textarea></td>
                </tr>
                <tr>
                    <td>Desa</td>
                    <td colspan="1"><input type="text" name="desa" id="desa" class="textinput" value="<?php echo $data_pindahdatang->desa; ?>"/></td>
                    <td>&nbsp;</td>
                    <td>&nbsp;</td>
                </tr>
                <tr>
                    <td>&nbsp;</td>
                    <td colspan="1">&nbsp;&nbsp;&nbsp;Dusun      
                        <input type="text" name="dusun" id="dusun" class="textinputtiga" value="<?php echo $data_pindahdatang->dusun; ?>"/></td>
                    <td>RT&nbsp;&nbsp;&nbsp;
                        <input type="text" name="rt_asal" id="rt_asal" class="textinputdua" value="<?php echo $data_pindahdatang->rt; ?>"/></td>
                    <td>RW&nbsp;&nbsp;&nbsp;
                        <input type="text" name="rw_asal" id="rw_asal" class="textinputdua" value="<?php echo $data_pindahdatang->rw; ?>" /></td>
                </tr>
                <tr>
                    <td>&nbsp;</td>
                    <td colspan="1">&nbsp;&nbsp;&nbsp;Kec.&nbsp;&nbsp;&nbsp;&nbsp;
                        <input type="text" name="kecamatan" id="kecamatan" class="textinputtiga" value="<?php echo $data_pindahdatang->kecamatan; ?>"/></td>
                    <td>Kab.
                        <input type="text" name="kabupaten" id="kabupaten" class="textinputtiga" value="<?php echo $data_pindahdatang->kabupaten; ?>"/></td>
                    <td>Prop.                  
                        <select name="idpropinsi" id="idpropinsi" class="list" value="<?php echo $data_pindahdatang->idpropinsi; ?>">
                            <?php
                            if (isset($propinsi)) {
                                foreach ($propinsi->result() as $data_propinsi) {
                                    echo '<option value="' . $data_propinsi->idpropinsi . '">' . $data_propinsi->propinsi . '</option>';
                                }
                            }
                            ?>
                        </select></td>
                </tr>
                <tr>
                    <td>&nbsp;</td>
                    <td colspan="1">&nbsp;&nbsp;Kd. Pos
                        <input type="text" name="kodepos" id="kodepos" class="textinputtiga" value="<?php echo $data_pindahdatang->kodepos; ?>"/></td>
                    <td colspan="2">Telp.
                        <input type="text" name="telp" id="telp" class="textinputtiga" value="<?php echo $data_pindahdatang->telp; ?>"/></td>
                </tr>
                <tr>
                    <td>Jumlah Keluarga yang Datang</td>
                    <td><input type="text" name="jumlah_keluargadatang" id="jumlah_keluargadatang" class="textinputdua" value="<?php echo $data_pindahdatang->jumlah_keluargadatang; ?>"/>
                        orang</td>
                    <td colspan="2">&nbsp;</td>
                    <td>&nbsp;</td>
                </tr>

                <tr>
                    <td>&nbsp;</td>
                    <td width="259">&nbsp;</td>
                    <td colspan="2">&nbsp;</td>
                    <td>&nbsp;</td>
                </tr>
                <tr>
                    <td>&nbsp;</td>
                    <td><input type="submit" name="ubah" id="ubah" value="Ubah" class="btn btn-large""/></td>
                    <td width="212">&nbsp;</td>
                    <td width="359">&nbsp;</td>
                    <td width="1">&nbsp;</td>
                </tr>
            </table>

        </form>
    </body>
</html>
